The Current Landscape of Medication Use
Recent data from the CDC's National Health Statistics Reports show that, for 2021–2022, 88.6% of adults aged 65 and older used at least one prescription medication within the previous 12 months. This statistic highlights the widespread role of medicine in managing age-related health issues. Notably, medication use varies by age within this demographic, with those aged 75–84 and 85+ being more likely to take medication than the 65–74 age group. A person's number of chronic conditions is also strongly correlated with their medication usage.
Polypharmacy: The Increase in Multiple Medications
Taking one medication is common, but taking multiple, a condition known as polypharmacy, is also prevalent and growing among older adults. A 2024 analysis found that more than 40% of adults aged 65 or older used five or more prescription medications in the past 30 days between 2017 and 2020. This represents a significant increase, with the rate of polypharmacy nearly doubling over the past two decades. For a subset of older adults, the situation is even more critical, with nearly 20% reportedly taking ten or more drugs. This rise is largely driven by a combination of the aging population, better treatment for chronic diseases, and a longer life expectancy.
The Compounding Risks of Polypharmacy
The simultaneous use of multiple medications is not without risks. Taking several drugs can lead to complex drug-drug interactions and an increased risk of adverse drug events (ADEs). The Lown Institute reports that over 750 older Americans are hospitalized daily due to serious medication side effects. The risks of polypharmacy include:
- Increased ADEs: Taking multiple medications can overwhelm the body's systems, leading to unintended side effects that can range from minor to life-threatening.
- Cognitive Impairment: Polypharmacy is associated with a higher risk of cognitive decline in older adults.
- Increased Healthcare Costs: Higher medication use drives up healthcare costs, both for the individual and the system.
- Nonadherence: Complex medication schedules can make adherence difficult, leading to missed doses or incorrect usage. Forgetting medications is a common issue.
- Risk of Falls: Certain medication combinations can increase the risk of dizziness, unsteadiness, and falls, a leading cause of injury for older adults.
Challenges with Access and Adherence
While many older adults rely on medication, many face significant barriers to taking them correctly. A 2019 KFF data note highlighted that one in five older adults did not take their medication as prescribed due to cost. Reasons included skipping doses, cutting pills, or not filling prescriptions at all. The cost barrier disproportionately affects those with low income and those with no prescription drug coverage. Factors like confusion over changing pill appearance and difficulty opening containers can also affect proper adherence.
A Comparative Look at Medication Use
| Factor | Younger Adults (e.g., 50-64) | Older Adults (e.g., 65+) |
|---|---|---|
| Use of at least one prescription | ~75% | ~89% |
| Use of four or more prescriptions | ~32% | ~54% |
| Primary Drivers of Medication Use | Often one or two specific conditions. | Multiple chronic conditions (multimorbidity). |
| Risks | Generally lower risk of adverse drug events and interactions due to fewer medications. | Higher risk of polypharmacy, adverse drug events, and drug interactions. |
Strategies for Safer Medication Management
To mitigate the risks associated with high medication use, especially polypharmacy, several best practices are recommended:
- Conduct Regular Medication Reviews: Older adults should have an annual medication review with their primary care physician. This involves bringing all medications, including over-the-counter drugs and supplements, to the appointment for a comprehensive check.
- Explore Deprescribing: Deprescribing, the process of reducing or stopping medications that may be causing harm or are no longer necessary, is an important strategy for senior care.
- Use a Single Pharmacy: Using one pharmacy for all prescriptions can help pharmacists monitor for potential drug-drug interactions and ensure consistency in care.
- Communicate with Providers: It's crucial for older adults and their caregivers to openly discuss all medications, including supplements, with their doctors.
- Utilize Medication Aids: Pill organizers and apps can help manage complex regimens and improve adherence.
By actively managing medication and maintaining open communication with healthcare providers, older adults can ensure they are taking the most appropriate and safest regimen for their needs. Resources are available from health organizations to aid in this process. For more information on medication safety and healthy aging, visit the National Institute on Aging website.
Conclusion
While a high percentage of older adults take medication as a necessary part of managing their health, the increase in polypharmacy brings significant concerns. The statistics reveal a complex reality where many seniors navigate multiple medications, leading to potential risks from adverse effects to poor adherence. By understanding the prevalence and risks, older adults, families, and healthcare providers can implement better strategies for safer and more effective medication management, ultimately promoting a healthier and higher quality of life.
